| Outcome |
Relative effect
(95% CI) |
Absolute effect
(95% CI)1 |
Certainty of the Evidence
(GRADE) |
Clinical improvement
D28 |
RR: 0.81
(0.63 - 1.05) |
113 fewer per 1000
(from 221 fewer to 30 more)
|
Very low certainty
Reasons to downgrade
Risk of bias: Not serious Inconsistency: Not serious Indirectness: Serious
despite a multicentre design this is a single study from a single country, therefore results in this population might not be generalizable to other settings. Imprecision: Very serious
due to very wide confidence interval consistent with the possibility for no effect and the possibility for harm and low number of participants
|
| 1 trials
Puskarich M, 2021
205 participants
|
|
Losartan
483 per 1,000
(376 - 626) |
Standard care/Placebo
596
per 1,000 |
|
Clinical improvement
D60 |
RR: 1.02
(0.78 - 1.33) |
17 more per 1000
(from 191 fewer to 286 more)
|
Very low certainty
Reasons to downgrade
Risk of bias: Serious
Risk of bias downgraded by 1 level: high risk of bias due to some concerns regarding adequate randomization, deviation from intended intervention, outcome measurement and selection of the reported results Inconsistency: Not serious Indirectness: Serious
despite a multicentre design this is a single study from a single country, therefore results in this population might not be generalizable to other settings. Imprecision: Very serious
due to very wide confidence interval consistent with the possibility for benefit and the possibility for no effect and low number of participants
|
| 1 trials
Geriak M, 2021
32 participants
|
|
Losartan
884 per 1,000
(676 - 1000) |
Standard care/Placebo
867
per 1,000 |
|
WHO progression score (level 7 or above)
D28 |
Outcome not yet measured or reported
|
|
WHO progression score (level 7 or above)
D60 |
Outcome not yet measured or reported
|
1 study was identified that assessed this outcome, but no results were reported. |
All-cause mortality
D28 |
RR: 1.26
(0.54 - 2.91) |
23 more per 1000
(from 40 fewer to 165 more)
|
Very low certainty
Reasons to downgrade
Risk of bias: Not serious Inconsistency: Not serious Indirectness: Serious
despite a multicentre design this is a single study from a single country, therefore results in this population might not be generalizable to other settings. Imprecision: Very serious
due to very wide confidence interval consistent with the possibility for benefit and the possibility for harm
|
| 1 trials
Puskarich M, 2021
205 participants
|
|
Losartan
109 per 1,000
(47 - 252) |
Standard care/Placebo
87
per 1,000 |
|
All-cause mortality
D60 |
RR: 1.13
(0.55 - 2.35) |
13 more per 1000
(from 44 fewer to 132 more)
|
Very low certainty
Reasons to downgrade
Risk of bias: Not serious Inconsistency: Not serious Indirectness: Serious
studies from a single country, therefore results in this population might not be generalizable to other settings. Imprecision: Very serious
due to very wide confidence interval consistent with the possibility for benefit and the possibility for harm
|
| 2 trials
Puskarich M, 2021; Geriak M, 2021
250 participants
|
|
Losartan
110 per 1,000
(54 - 229) |
Standard care/Placebo
98
per 1,000 |
|
Viral negative conversion
D7 |
Outcome not yet measured or reported
|
|
Adverse events
|
Outcome not yet measured or reported
|
|
Serious adverse events
|
Outcome not yet measured or reported
|
|
1The risk in the intervention group (and its 95% confidence interval) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI)
CI: Confidence interval; RR: Risk ratio
GRADE Working Group grades of evidence
High certainty: We are very confident that the true effect lies close to that of the estimate of the effect
Moderate certainty: We are moderately confident in the effect estimate: The true effect is likely to be close to the estimate of the effect, but there is a possibility that it is substantially different
Low certainty: Our confidence in the effect estimate is limited: The true effect may be substantially different from the estimate of the effect
Very low certainty: We have very little confidence in the effect estimate: The true effect is likely to be substantially different from the estimate of effect
